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Value Options Insurance Coverage for Drug and Alcohol Rehab

Drug and alcohol dependency, like any other chronic disease, requires treatment. The cure aims to undo the substance's effects and restore the body's chemical balance. Some methods used in treating the patient may require the patient to be housed in an inpatient rehab facility. Many people in need of treatment may shy away from inpatient treatment due to the associated cost, which most consider too expensive. Only 11% of people suffering from substance use disorders receive therapy compared to 70% of individuals suffering from diabetes and hypertension.

What To Know About Your Value Options Insurance

Our Admissions Experts Will Help You Navigate This Difficult Information. 

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Typically, co-insurance percentage range from 20% to 40%, and the insurance company clears the rest.

The amount you pay out-of-pocket for treatment before the health plan starts helping with payments.

Co-pay is a fixed amount you must clear (usually when you receive treatment) for covered treatment services.

How Does the Value Options Insurance Coverage for Drug and Alcohol Rehab Work?

Value Options administers behavioral health coverage to individuals with health policy plans that are either fully funded or funded by the state or local governments. Value Options insurance coverage contains a list of licensed and certified providers and facilities through which members can access different behavioral wellness services. Federal state laws require that health plans for substance abuse provide the same coverage as medical/surgical coverage.


A person seeking behavioral health therapy will visit a healthcare provider who will determine the kind of remedy necessary for the individual. Inpatient rehabilitation requires preauthorization requests or notifications, which the provider will file on behalf of the patient. The plan will then review whether the treatment is needful or which category it falls into. Treatment could be inpatient, intensive outpatient, or partial hospitalization.

Did You Know Rolling Hills Recovery Center Accepts Value Options Insurance? 

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Does Value Options Insurance Coverage Cater To All Drug and Alcohol Rehabilitation?

A request for drug or alcohol rehabilitation can be approved or denied. If the service is already provided, the patient will claim benefits from the Value Options insurance. Value Options may pay the claim immediately, or the claim may be denied.


The plan provider will most likely deny a claim after conducting a utilization review for the claim. Any treatment that fails to meet the threshold of medical necessity will most likely be denied. One of the criteria used is that a patient seeking inpatient facility options for drug and alcohol abuse should have first attempted and used an outpatient service and failed. A patient, however, has a right to appeal a denied request.

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Understanding Value Options Insurance Coverage

Some common words or phrases are important to understand in drug and alcohol therapy medicaments.


Outlier Patient: A patient hospitalized for an extended period or has spent significant amounts of cost beyond the typical expenditure on long-term care.


In such a case, Value Options insurance coverage may need further information to help determine the utilization of the treatment.

Complex Diagnosis: A patient with more than one addiction, for instance, drug and alcohol use disorder, is said to have a complex diagnosis. The treatment of one could affect the other, and the outcome could be adverse.


Complex diagnosis may affect the choice of health care provider, duration of treatment and plans, and hence cost.


Benefits Plan: These are available to the patient under the insurance coverage. A benefit plan considers the number of premiums paid under a policy.


The benefits cover medically necessary procedures. The kind of benefit plan determines the compensation of a claim.

Treatment Limitations: This is a restriction regarding the regularity of treatment, the permitted number of visits, and the days covered by a policy required for a treatment cycle. Mental health patients and those suffering from substance abuse disorders should be covered equally as those with other medical or surgical conditions. 


Out-of-Pocket Costs: These are payments that are not covered by your insurance and cannot be claimed.

The payments include the following;

  • A co-payment is an amount a patient must pay when seeking health services.

  • Deductibles are when a patient needs to pay for a certain amount of money up to a specific duration before the insurance coverage begins to cover the treatment.

  • It is essential to know that, as a patient, some preventive services are financed by your insurer whether or not out-of-pocket costs are part of the agreement.


You can pay a set limit for the out-of-pocket cost, known as the maximum out-of-pocket. For an individual, the amount should not exceed $8700 per annum and $17,400 for a family, in accordance with the 2022 plan.

Why Recover With RHRC?

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There are affordable options for addiction treatment

Rolling Hills Recovery Center works with a variety of healthcare providers.


Rolling Hills Recovery Center is dedicated to your success. We provide evidence-based treatments backed by science and holistic therapies that heal the mind, body, and spirit.

  • We are fully accredited

  • Mater level clinicians

  • We treat you as an individual

  • Respectful and peaceful setting

  • Insurance is accepted

Value Options
Value Options covers many addiction treatment services.
Rolling Hills Recovery Center accepts a variety of Value Options insurance coverage.

Medically Reviewed:


Rolling Hills Recovery Center

Expert Contributor

Dr. Williams presently serves on the board of Directors for two non-profit service organizations. He holds a Master’s degree in Human Services from Lincoln University, Philadelphia, Pa and a Ph.D. with a concentration in Clinical Psychology from Union Institute and University. In Cincinnati, Ohio. He is licensed to practice addictions counseling in both New Jersey and Connecticut and has a pending application as a practicing Psychologist in New Jersey.

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What Will Value Options Insurance Cover?

Value Options insurance policy will take care of an amount in your bill depending on the procedure's medical necessity and the policy's terms.


  • The intervention cost includes the assessment done to provide the diagnosis. Experimental and clinical trials are excluded.

  • Any detox plans necessary for the rehab may include medication and hospitalization of the patient. Some patients may need inpatient services or out-of-home rehabilitation to manage their withdrawal syndromes and keep them away from their triggers.

  • Round-the-clock emergency services for drug and alcohol use disorder.

  • Assessment and treatment of psychological and psychiatric disorders could be essential in the proposed treatment of the alcohol and drug disorder patient.

  • Maintenance therapy. An aftercare regimen is required while the patient is recovering. After detox and rehabilitation, follow-up is needed to ensure a patient does not fall back.

The medication program for a person should not have significant discrepancies from what is considered the norm.

What Determines the Treatment Program for Drug and Alcohol Use Disorder?

The treatment approach program will differ contingent on the magnitude of the condition. Some patients may need inpatient intensive care for patients that need full rehabilitation, detoxing, and management of severe withdrawal syndrome. Residential care will be helpful for a patient who needs 24 hours therapy outside the hospital environment requiring a person's therapy and medical needs. Some may need regular outpatient service reviews. A healthcare professional will evaluate and determine a person's treatment and medical conditions.


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Bottom Line

Value Options health plan for drug and alcohol use disorder offers the crucial support you need to get the best care for your mental wellness. Members have access to a broad network of providers, tailored premiums, and treatment strategies to aid them in their recovery journey.

Whether you seek a Medicare plan, employer plan, government or union plan or plans for individuals and families, Value Options insurance coverage will sort it out.


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How does the Value Options insurance coverage for drug and alcohol rehab work?
Does Value Options insurance coverage cater to all drug and alcohol rehabilitation?
Understanding Value Options insurance coverage
What will Value Options insurance cover?
What determines the treatment program for drug and alcohol use disorder?
Bottom line

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